Mobilization of a peritoneal dialysis catheter using an extra-corporeal magnet: preliminary experimental phase study
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NEPHROLOGY - ORIGINAL PAPER
Mobilization of a peritoneal dialysis catheter using an extra‑corporeal magnet: preliminary experimental phase study Victor Srougi1,2,3 · Limirio M. Fonseca1 · Luca J. Zampolli1 · Ana Beatriz Madeira Boffa1 · Hiury S. Andrade1 · Marco A. Arap1 · Ricardo J. Duarte1 · William C. Nahas1 · Miguel Srougi1 Received: 21 April 2020 / Accepted: 30 July 2020 © Springer Nature B.V. 2020
Abstract Purpose To evaluate in an experimental model, the mobility of a novel peritoneal dialysis catheter with a metallic tip (MagCath) using an extra-corporeal magnet. Materials and methods The Mag-Cath was installed in a porcine model under general anesthesia using laparoscopic access. A senior urologist, a urology resident, and a 3rd-year medical student were assigned to complete 2 tasks guided by fluoroscopy: (1) Move the catheter tip from the right flank to the pelvis and (2) move the catheter tip from the pelvis to the left flank. Accomplishment and time to complete the tasks were recorded. Participants were asked independently to grade the difficulty of the tasks using an analog scale from 1 (extremely easy) to 10 (extremely difficult). Results All participants completed the tasks. The difficulty of the tasks was graded equal to 1 by the senior urologist and urology resident and equal to 3 by the medical student. The time to move the Mag-Cath from the right flank to the target was 14, 10, and 55 s for the senior urologist, urology resident, and medical student, respectively. The time to move the Mag-Cath from the target to the left flank was 17, 18, and 43 s for the senior urologist, urology resident, and medical student, respectively. Conclusion In this preliminary analysis, the use of an extra-corporeal magnet to move the Mag-Cath was feasible, with a low grade of difficulty, and individuals with different levels of expertise could perform it. Further studies in human subjects are needed to evaluate the clinical applicability of the Mag-Cath properly. Keywords Peritoneal dialysis · Catheter · Complications · Magnet
Introduction It is estimated that approximately 11% of the individuals with kidney failure on dialysis perform peritoneal dialysis (PD) worldwide [1]. PD extends life expectancy when compared to in-center hemodialysis and provides a better quality of life because of the home therapy character [2]. However, complications related to the PD catheter may occur in 13% of the patients, most frequently leakage and obstruction [3]. Obstructed catheters can be managed with * Victor Srougi [email protected] 1
Division of Urology, University of São Paulo Medical School, São Paulo, Brazil
2
Hospital Moriah, São Paulo, Brazil
3
Department of Urology, Hospital das Clínicas de São Paulo, Av Enéas de Carvalho Aguiar, 255, São Paulo, SP 05403‑000, Brazil
simple maneuvers, including administration of oral laxatives, a vigorous saline flush of the catheter, and infusion of a fibrinolytic agent. Even so, roughly 40% of the patients will undergo surgery to review, replace, or remove the PD
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